Adult Insurance Waiver

Insurance Waiver for Adults

Prefer to use paper?
Click here to download the form.

Bethany United Methodist Church Leisure Ministries

Step 1. Select sport that are you currently signing up for:

Step 2. Fill in personal information:

First name:

Last name:

Age:

Date of birth:

Team name:

Street address:

City:

Zip:

Phone:

Email:

Please note:
This waiver is only valid for those participants who are 18 and older.

Step 3. Please read: By submitting this form, I agree to participate in an
activity sponsored by Bethany United Methodist Church. I accept the fact that
injuries may occur while I participate and I understand that Bethany United
Methodist Church does not provide insurance. I also understand that I am
responsible for any injuries that may occur.
I agree that medical attention may be obtained on my behalf.

Step 4.

(click once)